ATI RN
ATI Pharmacology Proctored Exam 2023
1. A client is starting therapy with raloxifene. Which adverse effect should the client monitor for as instructed by the nurse?
- A. Leg cramps
- B. Hot flashes
- C. Urinary frequency
- D. Hair loss
Correct answer: B
Rationale: Hot flashes are a common adverse effect associated with raloxifene therapy. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent and treat osteoporosis in postmenopausal women. Hot flashes are a well-known side effect of SERMs due to their estrogen-like effects on the body. Leg cramps, urinary frequency, and hair loss are not typically associated with raloxifene therapy. Therefore, the nurse should instruct the client to monitor for hot flashes as part of the medication education.
2. When starting therapy with bicalutamide, a client should be instructed to monitor for which of the following adverse effects?
- A. Muscle pain
- B. Flushing
- C. Gynecomastia
- D. Hyperglycemia
Correct answer: C
Rationale: The correct answer is C: Gynecomastia. Bicalutamide, due to its antiandrogenic properties, can lead to gynecomastia in clients. This condition involves the development of breast tissue in males and is an important adverse effect to monitor when taking this medication. Choices A, B, and D are incorrect. Muscle pain and flushing are not commonly associated with bicalutamide use. Hyperglycemia is not a typical adverse effect of bicalutamide therapy.
3. A client has a new prescription for a Nitroglycerin transdermal patch. Which of the following instructions should the nurse include?
- A. Apply the patch to a different site each day.
- B. Remove the patch at bedtime each day.
- C. Apply the patch over an area with little or no hair.
- D. Keep the patch on for 24 hours at a time.
Correct answer: B
Rationale: The correct instruction for a Nitroglycerin transdermal patch is to remove it each day, usually at bedtime, to prevent tolerance. Keeping the patch on for 24 hours at a time can lead to tolerance development. Applying the patch to a different site each day is not necessary, as long as the area is rotated to prevent skin irritation. Applying the patch over an area with little or no hair is not a critical instruction for the Nitroglycerin patch.
4. A client is taking Digoxin and has a new prescription for Colesevelam. Which of the following instructions should the nurse include in the teaching?
- A. Take digoxin with your morning dose of colesevelam.
- B. Your sodium and potassium levels will be monitored periodically while taking colesevelam.
- C. Watch for bleeding or bruising while taking colesevelam.
- D. Take colesevelam with food and at least one glass of water.
Correct answer: D
Rationale: When taking colesevelam, it should be administered with food and at least 8 oz of water to ensure proper absorption and reduce the risk of gastrointestinal side effects. Taking colesevelam with food also helps in binding to bile acids efficiently. Options A, B, and C are incorrect because they do not provide the necessary instruction for taking colesevelam correctly or monitoring specific side effects associated with this medication.
5. A client with end-stage cancer receiving Morphine is prescribed Methylnaltrexone. The client's daughter asks why the provider prescribed Methylnaltrexone. Which of the following responses should the nurse make?
- A. The medication will increase your mother's respirations.
- B. The medication will prevent dependence on the Morphine.
- C. The medication will relieve your mother's constipation.
- D. The medication works with the Morphine to increase pain relief.
Correct answer: C
Rationale: The correct response is C: 'The medication will relieve your mother's constipation.' Methylnaltrexone is an opioid antagonist used to treat severe constipation unrelieved by laxatives in opioid-dependent clients. It works by blocking the mu opioid receptors in the GI tract, which helps alleviate constipation without affecting pain relief or causing withdrawal symptoms. Choices A, B, and D are incorrect. Methylnaltrexone's primary action is related to managing constipation rather than increasing respirations, preventing dependence on Morphine, or enhancing pain relief when used alongside Morphine.
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